VATS lobectomy reduces cytokine responses compared with conventional surgery

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Immunology

Background:

• Video-assisted thoracic surgery (VATS) lobectomy is a feasible approach for early lung cancer.
• Laparoscopic procedures may reduce inflammatory reactions compared to open surgery.
• Cytokine responses following VATS versus conventional lobectomy for stage I lung cancer require investigation.

Purpose of the Study:

• To investigate and compare the cytokine responses after VATS lobectomy and conventional thoracotomy for clinical stage I lung cancer.

Main Methods:

• Thirty-six patients with clinical stage I non-small cell lung cancer were divided into two groups: 18 underwent VATS lobectomy and 18 underwent conventional thoracotomy.
• Plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, IL-8, and IL-10 were measured at multiple time points before and after surgery.
• Patient demographics, pulmonary function, tumor characteristics, and complications were similar between groups, ensuring comparability.

Main Results:

• No mortality or major complications occurred in either group.
• VATS lobectomy demonstrated significantly lower levels of IL-6 and IL-8 at the end of surgery compared to the open group.
• Reduced release of the anti-inflammatory cytokine IL-10 was also observed in the VATS group shortly after surgery.

Conclusions:

• VATS lobectomy is associated with a reduced postoperative release of both pro-inflammatory (IL-6, IL-8) and anti-inflammatory (IL-10) cytokines compared to the open surgical approach.
• These findings suggest a potentially less inflammatory systemic response following VATS.
• The long-term clinical significance of these observed cytokine differences warrants further investigation.